• The Korean Journal of Pain
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• 제32권3호
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• pp.178-186
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• 2019

Background: Epidural steroid injections (ESIs) have been widely used in managing spinal pain. Dexamethasone has recently emerged as a useful drug in this setting, relative to particulate steroids, although the associated systemic effects have not been fully elucidated. This study aimed to investigate the incidences and types of systemic effects after fluoroscopically guided ESI with dexamethasone. Methods: This retrospective study included 888 ESIs with dexamethasone (fluoroscopically guided at the cervical and lumbosacral levels) performed on 825 patients during January to June 2017. Data regarding systemic effects were collected via telephone interviews using a standardized questionnaire at 2 weeks after the procedure. Data on patient demographic, clinical, and procedural characteristics were collected and analyzed to identify factors that were associated with systemic effects. All statistical analyses were performed using the chi-squared test. Results: Among the 825 patients, 40 patients (4.8%) experienced systemic effects during the 2-week follow-up period. The most common systemic effect was facial flushing (12 patients, 1.5%), which was followed by urticaria (7 patients, 0.8%) and insomnia (7 patients, 0.8%). A history of spine surgery was significantly associated with the occurrence of systemic effects (P = 0.036). Systemic effects were significantly more common for injections at the cervical level than at the lumbar level (P = 0.019). Conclusions: Approximately 4.8% of the patients who underwent ESI with dexamethasone experienced minor and transient systemic effects. These effects were more common in patients who had undergone a previous spine surgery or received a cervical ESI.

• Archives of Pharmacal Research
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• 제20권1호
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• pp.24-28
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• 1997

In the present study, a pharmacokinetic model to address the effects of the diffusional barrier between splanchnic bed and enterocytes on the extent of presystemic and systemic intestinal elimination of drugs was developed. The model is composed of five compartments, ie., gut lumen, enterocyte, splanchnic bed, liver and central compartments. The equations for various pharmacokinetic parameters important for estimating the quantitative differences between presystemic and systemic intestinal and hepatic elimination of drugs were derived. A simulation study demonstrated that the diffusions[ barrier present between splanchnic blood and enterocytes can have significant effects on oral bioavailability and systemic clearance of drugs. In conclusion, the model can be useful for a better understanding of the effects of diffusional barrier on the extent of administration-route dependent intestinal and hepatic elimination of drugs, especially those with high hydrophilicity and/or charge(s) under physiological conditions.

• Archives of Pharmacal Research
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• 제22권3호
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• pp.279-287
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• 1999

Therapeutic use of anti-inflammatory steroids is limited due primarily to their systemic suppressive effects on pituitary function and the immune system.. To overcome the clinical limitation, a new approach toward the discovery of non-systemic anti-inflammatory steroids is based upon the antedrug concept introduced by this laboratory. The new concept describes locally active agents which are designed to undergo a predictable biotransformation to inactive metabolites upon entry into systemic circulation from the applied site. Thus, true antedrugs are devoid of systemic adverse effects. In a continuing effort, 16$\alpha$-carboxylate and isoxazoline derivatives of prednisolone have been synthesized and screened. In the croton oil-induced ear edema bioassay, the following relative potencies were obtained setting hydrocortisone=1.0; 3a, 1.5; 3b, 3.1; 4a, 4.0; 4b, 12.2; 5b, 8.2; 6b, 11.2; 7a, 1.9; 7b, 4.1; 8a, 3.3; 8b 6.8; 9a, 0.7; 9b 8.6; 10a 2.6; 10b, 7.4. Results of the five-day bioassay indicated that, in contrast to the parent compound, the novel steroidal antedrugs did not significantly alter body weight gain, thymus weights, adrenal weights or plasma corticosterone levels. Taken together, the antedrug concept appears to be a fundamentally sound strategy for the separation of local anti-inflammatory activity form systemic adverse effects.

• Archives of Pharmacal Research
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• 제12권2호
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• pp.63-67
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• 1989

The various esters of 20R and 20S-dihydroprednisolonic acid were prepared and evaluated for their local and topical anti-inflammatory activities in rats, including systemic effects. It was demonstrated that the size of the substituent at C-21 and configurational arrangement at C-20 have significant effects on local and topical activity. It was also found that all the derivatives did not show systemic effects as accessed by thymus weight and adrenal weight at the dose level used, while prednisolone showed profound effects on thymus weight.

• Biomolecules & Therapeutics
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• 제32권4호
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• pp.432-441
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• 2024

Systemic sclerosis is an autoimmune disease characterized by inflammatory reactions and fibrosis. Myofibroblasts are considered therapeutic targets for preventing and reversing the pathogenesis of fibrosis in systemic sclerosis. Although the mechanisms that differentiate into myofibroblasts are diverse, transforming growth factor β (TGF-β) is known to be a key mediator of fibrosis in systemic sclerosis. This study investigated the effects of extracellular vesicles derived from human adipose stem cells (ASC-EVs) in an in vivo systemic sclerosis model and in vitro TGF-β1-induced dermal fibroblasts. The therapeutic effects of ASC-EVs on the in vivo systemic sclerosis model were evaluated based on dermal thickness and the number of α-smooth muscle actin (α-SMA)-expressing cells using hematoxylin and eosin staining and immunohistochemistry. Administration of ASC-EVs decreased both the dermal thickness and α-SMA expressing cell number as well as the mRNA levels of fibrotic genes, such as Acta2, Ccn2, Col1a1 and Comp. Additionally, we discovered that ASC-EVs can decrease the expression of α-SMA and CTGF and suppress the TGF-β pathway by inhibiting the activation of SMAD2 in dermal fibroblasts induced by TGF-β1. Finally, TGF-β1-induced dermal fibroblasts underwent selective death through ASC-EVs treatment. These results indicate that ASC-EVs could provide a therapeutic approach for preventing and reversing systemic sclerosis.

• Journal of Physiology & Pathology in Korean Medicine
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• 제26권5호
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• pp.693-698
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• 2012

This study was designed to investigate the effects of 1-fluoro-2,4 dinitrobenzene (DNFB) on Induction of dermatitis in mice. We investigated the effects of DNFB on induction of dermatitis in terms of changes in body weights, ear thickness, ear weight, spleen/body ratio, histopathological observation and cytokine productions in inflammed tissue of contact dermatitis (CD) mice. In our experiments, we induced CD by using two different methods. First, mice were sensitized and challenged on the back of each ear (topical induction). Second, mice were sensitized on shaved back and challenged back of each ear (systemic induction). In our results, average weights were lowered in both topical and systemic group. But, there was no statistical significance between topical and systemic group. Treatment with DNFB enlarged ear weights and thicknesses in both topical and systemic groups. In addition, both groups were showed almost same features such as immune cell infiltration, spongiosis and hyperplasia in histopathological observations. Finally production levels of TNF-a, IFN-g and IL-6 were markedly elevated in both topical and systemic groups. On the other hand, systemic induction was more effective in spleen/body ratio and IL-6 production compared to topical induction respectively. These results suggest that dermatitis model using DNFB was used as model of CD, not for atopic dermatitis model.

• Journal of Oral Medicine and Pain
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• 제40권1호
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• pp.10-16
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• 2015

Purpose: Pilocarpine has the effects on improvement of salivary flow and subjective symptoms for xerostomic patients. Because of unwanted side effects following its systemic administration, topical pilocarpine has been paid attention as an alternative. This study aimed to investigate effects of pilocarpine solution as mouthwash on salivary flow and adverse effects compared to systemic administration of 5 mg pilocarpine tablet in healthy subjects. Methods: The study was a double blind, placebo-controlled, crossover clinical trial. Five milligrams pilocarpine tablets, 4 mL of 2% pilocarpine solution and placebo solution were given to 12 healthy volunteers (6 males and 6 females) in a predetermined order with wash-out period of at least two days and unstimulated whole saliva was collected before and after administration of each drug. Blood pressure and pulse rate was also measured and subjective effect and potential side effects were evaluated by a self-administrated questionnaire. Results: Systemic (5 mg tablet) and topical (2% solution) use of pilocarpine significantly increased salivary flow rate in healthy subjects compared to placebo (p<0.001). In both the pilocarpine solution and tablet groups, salivary flow rates at 120 minutes after administration remained increased. Subjective effect on salivation was the largest in the pilocarpine tablet group, followed by the pilocarpine solution group (p<0.05). There was no significant difference in blood pressure and pulse rate after administration of all three drugs. Fewer side effects reported in the pilocarpine solution group than in the tablet group. Conclusions: Two percents pilocarpine solution as mouthwash increases salivary flow rate, definitely superior to placebo solution and comparable to pilocarpine tablet, with fewer side effects in healthy subjects. It indicates a possibility of pilocarpine solution as a useful alternative of pilocarpine tablets for the xerostomic patients with systemic diseases.

• Journal of Korean Medical Ki-Gong Academy
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• 제1권1호
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• pp.95-109
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• 1996

To investigate anti-stress effects of Manual Kigong, Manual-Apparatus Combined Kikong, and Systemic Kigong, this experiments were performed changing of plasma catecholaminess and serum cortisol measured. Also using D.I.T.I(Digital Infrared Thermongraphy Imaging), Pulse Analyzer, Electric Current on Neurometer, and Digital Flicker on Testing-Stressed. And following results were abtained. 1) Menual-Appartus Combined Kikong decreased significantly increasing concentration of plasma epinephrine and norepinephrine level in Testing-stressed. 2) Manual Kigong decreased increasing concentration of serum cortisol level in Testing-stressed. 3) Manual Kigong and Manual-Aparatues Combined Kikong increased decreasing thermomerty on the palm's center caused Testing-stressed. 4) All of three treats are small change in SET(Systolic Ejection Time) by Pulse Analyzer caused Testing-stressed. 5) More changes of Electric Current on the Neurometer Diagnosis caused Testing-stressed are as followed. Manual-Apparatus Combined Kikong >Systemic Kigong >Manual Kigong From the results, it may be concluded that Manual-Apparatus Combined Kikong Theraphy having more anti-stress effects than Manual Theraphy. Systemic Kigong Therapy.

• Journal of Korean Clinical Nursing Research
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• 제25권2호
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• pp.170-178
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• 2019

Purpose: The purpose of this study was to determine the mediating effects of self-efficacy and the belief about medication on the association between depression and medication adherence in patients with systemic lupus erythematosus. Methods: 128 patients aged ${\geq}19years$, who were regular outpatients or admitted patients diagnosed with systemic lupus erythematosus at a tertiary hospital in B city, participated in this study. Data were collected by using a self-administered questionnaire. Testing of mediating effects was analyzed by a parallel redundant mediated model using the PROCESS macro for SPSS version 3.3. Results: They scored an average of $16.71{\pm}11.13$ for depression, $694.14{\pm}170.68$ for self-efficacy, $3.05{\pm}4.60$ for the belief about medication, and $90.14{\pm}15.37$ for medication adherence. The direct effect of depression on medication adherence was not statistically significant, but the indirect effects of depression mediated with self-efficacy and belief about medication were statistically significant. Conclusion: It is necessary to develop and apply a nursing intervention program that can not only relieve depression but also promote self-efficacy and the belief about medication with the objective of improving medication adherence among patients with systemic lupus erythematosus.

• Journal of Korean Academy of Nursing
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• 제34권6호
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• pp.1129-1142
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• 2004

Purpose: This research was conducted to evaluate the effects of asystemic follow-up care program on health promotion and risk reduction in 64 high-risk infants(HRI) including premature infants and their mothers. Method: The intervention consisted of systemic NICU education, tele-counseling and 3 home visits in 6 months. The subjects were divided into either the intervention group or the control group receiving the conventional NICU education without the tele-counseling and home visiting. Infant health promotion was measured using physical assessment, types of health problems, reflexes, OPD visiting history, DDST, immunization, feeding assessment, Infant death rate, etc. Maternal self-esteem, postpartum depression and family function were measured using the maternal self-report inventory(MRI), EPDS, and family apgar score(Fapgar), retrospectively. Result: All premature infants in the intervention group were in the normal range of growth and development, and the regular vaccination schedule. The health problems in the intervention group were addressed early so not to develop into adverse effects. The follow-up program for 6 months showed beneficial effects on MRI, EPDS, and Fapgar. Conclusion: A systemic follow-up health care program is beneficial on health promotion and risk reduction in 64 HRI including premature infants and their mothers.